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Abstract

The liver represents the most common site of metastasis for neuroendocrine tumors, and interventional treatment of these metastases represents an important treatment option. Hepatic neuroendocrine tumors can be treated through “bland” transarterial embolization, transarterial chemoembolization, selective internal radiation therapy (i.e., radioembolization), and percutaneous thermal ablation. Interdisciplinary discussion, including surgeons, oncologists, radiation oncologists, radiologists, and interventional radiologists, can best determine the role of locoregional therapies in the patient’s overall treatment plan. The goals of interventional treatments include reducing symptoms from active tumoral endocrine production and prolonging life as liver failure represents the most common cause of mortality in patients with liver-predominant neuroendocrine disease.

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References

  1. Ihse I, Lindell G, Tibblin S. Neuroendocrine tumors metastatic to the liver. In: Holzheimer RG, Mannick JA, editors. Surgical treatment: evidence-based and problem-oriented. Munich: Zuckschwerdt; 2001.

    Google Scholar 

  2. Qu C, Qu L, Zhu C, Wang Z, Cao J. Treatment of primary hepatic neuroendocrine tumors with associating liver partition and portal vein ligation for staged hepatectomy. Medicine. 2018;97(37):12408.

    Article  Google Scholar 

  3. Paulson EK, McDermott VG, Keogan MT, DeLong DM, Frederick MG, Nelson RC. Carcinoid metastases to the liver: role of triple-phase helical CT. Radiology. 1998;206:143–50.

    Article  CAS  Google Scholar 

  4. Dromain C, de Baere T, Baudin E, Galline J, et al. MR imaging of hepatic metastases caused by neuroendocrine tumors: comparing four techniques. AJR Am J Roentgenol. 2003;180(1):131–28.

    Article  Google Scholar 

  5. Mestier L, Lepage C, Baudin E, Coriat R, Courbon F, et al. Digestive neuroendocrine neoplasms (NEN): French intergroup clinical practice guidelines for diagnosis, treatment, and follow-up. Dig Liver Dis. 2020;52(5):473–92.

    Article  Google Scholar 

  6. Barat M, Cottereau A, Kedra A, Dermine S, Palmieri L, et al. The role of interventional radiology for the treatment of hepatic metastases from neuroendocrine tumor: an updated review. J Clin Med. 2020;9(7):2302.

    Article  Google Scholar 

  7. Clouse ME, Perry L, Stuart K, Stokes KR. Hepatic arterial chemoembolization for metastatic neuroendocrine tumors. Digestion. 1994;55(Suppl 3):92–7.

    Article  Google Scholar 

  8. Tsochatzis EA, Fatourou E, O-Beirne J, Meyer T, Burroughs AK. Transarterial chemoembolization and bland embolization for hepatocellular carcinoma. World J Gastroenterol. 2014;20(12):3069–77.

    Article  Google Scholar 

  9. Wang YJ, Baere TD, Idee J, Ballet S. Transcatheter embolization therapy in liver cancer: an update of clinical evidence. Chin J Cancer Res. 2015;27(2):96–121.

    PubMed  PubMed Central  Google Scholar 

  10. Allison DJ, Modlin IM, Jenkins WJ. Treatment of carcinoid liver metastases by hepatic-artery embolisation. Lancet. 1977;2(8052–8052):1323–5.

    Article  CAS  Google Scholar 

  11. Stokes KR, Stuart K, Clouse ME. Hepatic arterial chemoembolization for metastatic endocrine tumors. J Vasc Interv Radiol. 1993;4(3):341–5.

    Article  CAS  Google Scholar 

  12. ContourTM pva embolization particles [Internet]. www.bostonscientific.com. [cited 2020 Oct 20]. Available from: https://www.bostonscientific.com/en-US/products/embolization/contour-pva-embolization-particles.html.

  13. Zener R, Yoon H, Ziv E, Covey A, Brown K, et al. Outcomes after transarterial embolization of neuroendocrine tumor liver metastases using spherical particles of different sizes. Cardiovasc Intervent Radiol. 2019;42(4):569–76.

    Article  Google Scholar 

  14. Ang TL, Seewald S, Soehendra N. Endotherapy of gastric fundal varices: intravariceal injection of N-butyl-2-cyanoacrylate. Video J Encycl GI Endosc. 2013;1(1):157–9.

    Article  Google Scholar 

  15. Biolato M, Marrone G, Racco S, Di Stasi C, Miele L, et al. Transarterial chemoembolization (TACE) for unresectable HCC: a new life begins? Eur Rev Med Pharmacol Sci. 2010;14(4):356–62.

    CAS  PubMed  Google Scholar 

  16. Song JE, Kim DY. Conventional vs drug-eluting beads transarterial chemoembolization for hepatocellular carcinoma. World J Hepatol. 2017;9(18):808–14.

    Article  Google Scholar 

  17. Kim YH, Ajani JA, Carrasco CH, Dumas P, Richli W, et al. Selective hepatic arterial chemoembolization for liver metastases in patients with carcinoid tumor or islet cell carcinoma. Cancer Investig. 1999;17(7):474–8.

    Article  CAS  Google Scholar 

  18. Pelage J, Fohlen A, Mitry E, Lagrange C, Beauchet A, Rougier P. Chemoembolization of neuroendocrine liver metastases using streptozocin and tris-acryl microspheres: embozar (embosphere + zanosar) study. Cardiovasc Intervent Radiol. 2017;40(3):394–400.

    Article  Google Scholar 

  19. Poon R, Tso WK, Pang R, Ng K, Woo R, et al. A phase I/II trial of chemoembolization for hepatocellular carcinoma using a novel intra-arterial drug-eluting bead. Clin Gastroenterol Hepatol. 2007;5(9):1100–8.

    Article  CAS  Google Scholar 

  20. Lewis AL, Taylor RR, Hall B, Gonzalez MV, Willis SL, Stratford PW. Pharmacokinetic and safety study of doxorubicin-eluting beads in a porcine model of hepatic arterial embolization. J Vasc Interv Radiol. 2006;17(8):1335–43.

    Article  Google Scholar 

  21. Guiu B, Deschamps F, Aho S, Munck F, Dromain C, et al. Liver/biliary injuries following chemoembolisation of endocrine tumours and hepatocellular carcinoma: lipiodol vs drug-eluting beads. J Hepatol. 2012;56(3):609–17.

    Article  CAS  Google Scholar 

  22. Kitano M, Davidson GW, Shirley LA, Schmidt CR, Guy GE, et al. Transarterial chemoembolization for metastatic neuroendocrine tumors with massive hepatic tumor burden: is the benefit worth the risk? Ann Surg Oncol. 2016;23(12):4008–15.

    Article  Google Scholar 

  23. Cornelis FH, Monard E, Moulin MA, Vignaud E, Laveissiere F, et al. Sedation and analgesia in interventional radiology: where do we stand, where are we heading and why does it matter? Diagn Interv Imaging. 2019;100(12):753–62.

    Article  CAS  Google Scholar 

  24. Blackburn H, West S. Management of postembolization syndrome following transarterial chemoembolization for primary or metastatic liver cancer. Cancer Nurs. 2016;39(5):E1–18.

    Article  Google Scholar 

  25. Ishikawa T. Prevention of post-embolization syndrome after transarterial chemoembolization for hepatocellular carcinoma – is prophylactic dexamethasone useful, or not? Hepatobiliary Surg Nutr. 2018;7(3):214–6.

    Article  Google Scholar 

  26. Ubillus WJ, Munoz J, Vekaria M, Wollner IS, Getzen T, et al. Post-embolization syndrome: outcomes regarding the type of embolization. J Clin Oncol. 2011;29(15):e14582.

    Article  Google Scholar 

  27. Chen J, Wileyto EP, Soulen MC. Randomized embolization trial for neuroendocrine tumor metastases to the liver (RETNET): study protocol for a randomized controlled trial. Trials. 2018;19:390.

    Article  Google Scholar 

  28. Sundram FX, Buscombe JR. Selective internal radiation therapy for liver tumors. Clin Med (Lond). 2017;17(5):449–53.

    Article  Google Scholar 

  29. Narsinh KH, Buskirk MV, Kennedy AS, Suhail M, Alsaikhan N, et al. Hepatopulmonary shunting: a prognostic indicator of survival in patients with metastatic colorectal adenocarcinoma treated with 90Y radioembolization. Radiology. 2016;282(1):281–8.

    Article  Google Scholar 

  30. Salem R, Lewandowski R, Kulik L, Wang E, Riaz A, et al. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization patients with hepatocellular carcinoma. Gastroenterology. 2011;140(2):497–507.

    Article  Google Scholar 

  31. Sangro B, Gil-Alzugaray B, Rodriguez J, Sola I, Martinez-Cuesta A, et al. Liver disease induced by radioembolization of liver tumors: description and possible risk factors. Cancer. 2008;112(7):1538–46.

    Article  Google Scholar 

  32. Currie BM, Hoteit MA, Ben-Josef E, Nadolski GJ, Soulen MC. Radioembolization induced chronic hepatotoxicity: a single-center cohort analysis. J Vasc Interv Radiol. 2019;30(12):1915–23.

    Article  Google Scholar 

  33. Braat AJ, Kappadath SC, Ahmadzadehfar H, Stothers CL, Frilling A, et al. Radioembolization with 90y resin microspheres of neuroendocrine liver metastases: international multicenter study on efficacy and toxicity. Cardiovasc Intervent Radiol. 2019;42(3):413–25.

    Article  CAS  Google Scholar 

  34. Ryan MJ, Willatt J, Majdalany BS, Kielar AZ, Chong S, Ruma JA. Ablation techniques for primary and metastatic liver tumors. World J Hepatol. 2016;8(3):191–9.

    Article  Google Scholar 

  35. Lubner MG, Brace CL, Hinshaw JL, Lee FT. Microwave tumor ablation: mechanism of action, clinical results, and devices. J Vasc Interv Radiol. 2010;21(8 Suppl):S192–203.

    Article  Google Scholar 

  36. Henn AR, Levine EA, McNulty W, Zagoria RJ. Percutaneous radiofrequency ablation of hepatic metastases for symptomatic relief of neuroendocrine syndromes. Am J Roentgenol. 2003;181(4):1005–10.

    Article  Google Scholar 

  37. Mohan H, Nicholson P, Winter DC, O’Shea D, O’Toole D, et al. Radiofrequency ablation for neuroendocrine liver metastases: a systematic review. J Vasc Interv Radiol. 2015;26(7):935–42.

    Article  Google Scholar 

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Zacharias, K., Ahmed, O. (2022). Interventional Treatment of Hepatic Endocrine Tumors. In: Yu, H., Burke, C.T., Commander, C.W. (eds) Diagnosis and Management of Endocrine Disorders in Interventional Radiology. Springer, Cham. https://doi.org/10.1007/978-3-030-87189-5_20

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  • DOI: https://doi.org/10.1007/978-3-030-87189-5_20

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